3 October 2010 Last updated at 20:34 ET

Health unions query speed of government NHS reforms

By Branwen Jeffreys Health correspondent, BBC News

An overhaul of the NHS was announced in July

The speed and scale of the government's plans for the NHS in England have been questioned by health unions.

The Royal College of Nursing warns of a "highly ambitious timescale", while Unison says some key schemes go beyond the coalition's stated programme.

The unions are responding to plans for a radical reshaping of the NHS which were published earlier this year.

The government says reform is necessary and will give clinical staff a greater say in the NHS.

A timetable for change was set out in a government White Paper and health unions are submitting their responses as the public consultation draws to a close.

Under the proposals, groups of GPs would have to take control of most of the NHS budget by April 2013.

The primary care trusts that manage that money now and the regional tier of the NHS in England would be abolished at the same time.

All hospitals would have to become foundation trusts, which are more independent, by 2014.

Experts have described the changes as the biggest reorganisation of the NHS since its creation.

The Royal College of Nursing (RCN) says nurses support the underlying principles.

General secretary Dr Peter Carter said the RCN welcomed the principles behind the changes of greater freedom for NHS staff to make decisions, and a focus on the quality of healthcare.

But he raised concerns about the impact of the changes at a time of financial austerity in the health service.

Dr Carter said: "They show a radical shift in the way healthcare is managed and provided, at a time when the NHS faces some of the biggest financial challenges of its history."

The union describes the proposals as "untested" and says if they are pushed through without the support of staff and the risks being assessed, there might be a negative impact on care for patients.

It wants to see a more gradual approach, with pilots of the new system being evaluated to see how well they work.

Criticisms rejected

In its response Unison, which represents many lower paid NHS staff, also argues that there is a lack of any plans to pilot the new way of managing services.

Unison says so much change in such a short time frame will produce a period of instability which could have an impact on patients.

The union points out that the abolition of primary care trusts was not in the election manifestos of either the Conservatives or Lib Dems, nor in the coalition's programme for government.

Health Secretary Andrew Lansley, who will address the Conservative Party conference on Tuesday, has rejected the criticisms, arguing reform of the NHS is a necessity. He says the plans will deliver much more power to clinical staff.

"We need a healthcare system where the management of the care of patients is combined with an understanding of how resources are used," he said.

"Healthcare professionals are best placed to do this and know where resource is needed to improve outcomes for patients."

Mr Lansley pointed out that in some parts of the country GPs were keen to make a transition to taking on their new responsibilities, but accepted that others still had questions about how the new system would work.